SURGICAL APPROACH TO AORTAENTERIC FISTULAS: TWO CASE REPORT

Two patients having primary and secondary aortoenteric fistulas underwent emergent surgery due to their clinical unstability. Duodenal repair, graft resection and extraanatomic bypass (axillofemoral-femorofemoral) procedures were prefered as the surgical approach for the patient having secondary aortoenteric fistula, who was discharged on the fifth postoperative day. We applied duodenal repair, aneurysm resection, wide debridment and in situ graft replacement (aortobiiliac) on the patient having primary aortoenteric fistula; however, the patient died on twentysecond postoperative day due to sepsis and multisystem organ failure.

Since there is a risk of infection for aortoenteric fistulas, instead of performing in situ graft replacement, extraanatomic bypass procedure can be applied as an even better alternative. (Turkish J Vasc Surg 2003; 12(1): 35-37)